Funded by a grant from SHS International Limited, Liverpool, UK.AMD and WEM are to be considered Joint senior authors.
Enteral feeding therapy for newly diagnosed pediatric crohn's disease: A double-blind randomized controlled trial with two years follow-up†
Article first published online: 18 MAR 2011
Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 18, Issue 2, pages 246–253, February 2012
How to Cite
Grogan, J. L., Casson, D. H., Terry, A., Burdge, G. C., El-Matary, W. and Dalzell, A. M. (2012), Enteral feeding therapy for newly diagnosed pediatric crohn's disease: A double-blind randomized controlled trial with two years follow-up. Inflamm Bowel Dis, 18: 246–253. doi: 10.1002/ibd.21690
- Issue published online: 10 JAN 2012
- Article first published online: 18 MAR 2011
- Manuscript Accepted: 19 JAN 2011
- Manuscript Received: 3 NOV 2010
- Crohn's disease;
- fatty acids
This study compared the efficacy of an elemental formula (EF) to a polymeric formula (PF) in inducing remission for pediatric Crohn's disease (CD).
Newly diagnosed CD children were randomized to EF or PF for 6 weeks. Change in the Pediatric Crohn's Disease Activity Index (PCDAI), fecal calprotectin, and plasma fatty acids were measured at 0 and 6 weeks. Patients were followed up for 2 years. Time and treatment choice for first relapse were documented.
Thirty-four children completed the study; EF: 15 (7 M, 8 F), PF: 19 (13 M, 6 F). The mean age was (years) EF: 12.6, PF: 11.7. Ninety-three percent of children (14/15) achieved remission in the EF group and 79% (15/19) in the PF group. One-third of patients maintained remission for 2 years. Mean time to relapse (days); EF: 183 (63–286), PF: 162 (53–301). Most children who relapsed used feed as a treatment for that relapse (EF: 9/10 and PF: 8/13). With PF, an increase of eicosapentanoic acid (EPA) and alpha linolenic acid was found with a reciprocal decrease in arachidonic acid (AA). With EF, AA and EPA levels were reduced with a significant decrease in docosahexaenoic acid. Fecal calprotectin measurements decreased significantly but did not normalize at the end of week 6.
There was no significant difference between EF and PF in inducing remission. One-third of children maintained remission. Changes in plasma polyunsaturated fatty acid status were subtle and may be relevant; however, further evaluation is recommended. (Inflamm Bowel Dis 2011;)